Author: Resource-PC
Company: Health Systems Research, Inc.

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What Works: Systems Change Strategies

Improving Access to Mainstream Services for Homeless Families with Children

Carol Wilkins
Director of Intergovernmental Policy
Corporation for Supportive Housing

 January 28, 2004

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The Corporation for Supportive Housing

A national nonprofit intermediary organization

CSH helps communities create permanent housing with services to prevent and end homelessness

For more information visit www.csh.org 

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Why Systems Change?

•	Integrated services and supportive housing are products with proven effectiveness ending homelessness and improving outcomes for families with multiple barriers to work and stability – but without a system to produce them
•	Homeless families with children must hunt for and combine discrete services for their needs
•	Every project is a patchwork of authorizations and funding
•	Often, success means using money for purposes that weren’t officially intended

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Fragmented Systems 

Share responsibility for homeless families

•	Homeless Services
•	Social Services
•	Employment
•	Child Welfare
•	Education
•	Mental Health
•	Substance Abuse
•	Housing Development Finance 
•	Rent Subsidy
•	Hospitals, Clinics, Public Health

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What’s In a Changed System?

•	“Any door” leads to effective bundle of housing and services for families who are at risk of homelessness
•	Service and housing resources are allocated in a single or coordinated process, timed as needed for project implementation
•	Rules and funding not improvised project-by-project, or on exceptional basis, but established in routine practice

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Key Components of Systems and indicators of a changed system 

•	Power 
•	Money
•	Habits
•	Technology and Skills
•	Ideas and Values

… all linked to achieve a mission or goal

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Changes in Power

•	Duties and authority are rearranged
•	Designated positions are given formal authority and responsibility for supportive housing and other new activities to prevent and end family homelessness
•	Stakeholders who have not been heard or involved assume new or different roles

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Changes in Money

•	New money is used as a catalyst for change 
•	Old money (“mainstream resources”) is used in new ways through targeting, eligibility changes, technical solutions, incentives
•	Funding for all components of supportive housing projects (capital, operating, and supportive services) is available and reliable – and coordinated

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Changes in Habits

•	People and organizations interact with each other to create and sustain integrated solutions (housing and more effective services) for homeless families as part of their normal ongoing routines and core work activities
•	Requires new understanding and skills for working in a “multi-cultural” environment

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Changes in Technology & Skills

Skilled practitioners at all levels can effectively deliver results
•	Direct service delivery based on promising practices
•	Organizational capacity to engage in new activities or partnerships and to use new financing strategies
•	New procedures and systems and cross-training for government agencies to implement, monitor and evaluate new program activities

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Changes in Ideas and Values

•	A new understanding of the problems to be solved 
•	Re-examine traditional definitions of success across multiple systems
•	Re-define target populations based on shared priorities
•	New performance expectations and definitions of success are widely shared

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The “Art” of System Change

Besides their framework of rules and incentives, systems deal with behavior – habits, ideas, relationships

Change thus becomes a behavior-modification recipe: 
•	Persuasion
•	Incentives
•	Trust
•	Practice

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Coercion and its Limits

•	People can be forced to change, but only by superiors who will last long enough – and enforce the change long enough – to make it stick
•	Usually, that doesn’t happen. Politicians leave office, top executives have other priorities, and constant coercion is exhausting

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Effective Systems Change

Requires persistent pressure on most or all of the key elements over a sustained period of time 
•	This takes years, not months of effort 
To get there, often begins with:
•	Persuasive short-term accomplishments
•	Producing a new product or service by extraordinary means, just to show it can be done and is worth replicating

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Building to a ‘Tipping Point’

The spread of new ideas, habits, values, and know-how often comes from three forces:
•	Gifted “sellers” 
•	A receptive audience (aware of a need, or caught in a moment of crisis)
•	A message that “sticks” when delivered

(courtesy of Malcolm Gladwell)

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Building Blocks 
Tested Tactics of Systems Change

1.	Collaborative Planning
2.	Investment and Leveraging Resources
3.	Coordination, Streamlining, and Integration of Funding
4.	Building Provider Capacity
5.	Quality Assurance: Establishing and Monitoring Industry Standards

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Building Blocks 
Tested Tactics of Systems Change (continued)

6.	Research and Data 
7.	Communication and Advocacy
8.	Cultivating Leaders, Champions, and Advocates
9.	The Irresistible Force – Events that Compel Action
10.	An Intermediary as Neutral Catalyst

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Their Problem = Your Opportunity
“Head for the dysfunction”

Mainly, system reformers look for places in the old system where players are unhappy, frustrated, losing the race

Whoever feels the pain the worst may be your first ally

Most of all show them solutions – something they could take credit for.  Field trips to visit model programs often help!

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Expect Resistance
•	The tools of System Change are meant to unsettle old systems while building new ones
•	Old systems will resist – they exist because they have survived pressures and onslaughts before
•	Services and Housing are not just separate systems, but (many) separate cultures, disciplines, and sets of values

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Collaborative Planning
•	Consensus-building
•	Clarifying need and opportunity
•	Establishing numeric goals
•	Estimating costs/identifying resources
•	Planning together/sharing ownership
•	Accomplishing something together
•	Becoming used to working together – through MOUs, task forces, projects, etc.
•	Beginning to advance a wider change

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Who Should Collaborate?
•	Programs that target homelessness and mainstream programs
•	Housing: development and finance, rent subsidy
•	Services: family and children’s services, mental health, addiction treatment, health care, education, employment, juvenile and criminal justice
•	Create linkages to ongoing planning efforts to improve systems for families with multiple challenges to work and stability

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How Big a Group?
•	Large enough to include the people you need to get started – planners, funders, and builders who will actually be involved
•	Not so big that people feel marginal, bored, or unable to contribute

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Who Should Participate?
•	Usually not the top executives – they won’t stick with it
•	Usually not the front-line staff – they don’t have enough influence over the wider system
•	People who are trusted, influential, able to pull levers
•	Trusted bridge-builders or “boundary spanners”

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Investment and Leveraging Resources

•	New money is powerful, but scarce and hard to sustain
•	Most change is “old money” or mainstream resources used in new ways: 
o	TANF
o	Medicaid
o	Block Grants
o	State and local funding for family and children’s services
o	Affordable housing 

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Using old money in new ways

•	Changing eligibility rules 
o	Target populations
o	Providers or projects
o	Services
•	Targeting
o	Priorities or preferences
o	Set aside
•	Solving technical problems
•	Sustaining and increasing funding opportunities

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Coordination, Streamlining and Integration of Funding

Even when using money for the same purposes as before, a key goal is to make applications and the administration of funding consistent with the process and needs of supportive housing and other integrated responses to family homelessness

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Interagency Coordination planning bodies, task forces and MOU’s establish:

•	Consistent standards for eligibility and shared set of priorities
•	Single or coordinated application process for funding and project approvals
•	Calendar for applications and decisions that matches program development and start-up
•	Shared decision-making for multiple sources of funding 
•	Consistent and efficient reporting and oversight
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Grooming Champions and Leaders

•	The most effective champions aren’t always the most powerful individuals
•	Business people, budget officials, staff aides and advisers, all may be better than professional advocates or top elected officials
•	Needs to be passionate, untiring, a gifted “salesperson,” with a huge Rolodex and a convincing command of the subject

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Catalysts for systems change

Often the most effective broker for changing systems is a person or organization that is…
•	Independent of the old system. A new or outside force without longstanding alliances to factions that old systems failed to integrate
•	With a clear point of view, and a way out of the woods
•	Drawing from experience, not just ideas 

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Making the Case for Change

•	Communicate key results from research to policymakers: 
o	Focus on results instead of the problem
o	Keep it simple
o	Personal stories make an impact
o	Use the media
•	Use site visits and tours of promising projects to put a “face” on data and policy message

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Leadership for Change

•	“To accomplish great things, we must not only act, but also dream; not only plan, but also believe.”  
- Anatole France	
•	“Goals are dreams with deadlines.”  
- Diana Sharf Hunt 

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For more information
Read the new CSH publication
Laying a New Foundation: Changing the Systems that Create and Sustain Supportive Housing
Visit www.csh.org

Carol Wilkins
Director of Intergovernmental Policy
Corporation for Supportive Housing
carol.wilkins@csh.org